Provider Demographics
NPI:1427433507
Name:ASTUGUE, KEVIN C (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:ASTUGUE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROBERT E. LEE BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1326
Mailing Address - Country:US
Mailing Address - Phone:504-286-3880
Mailing Address - Fax:504-286-3882
Practice Address - Street 1:100 ROBERT E. LEE BLVD.
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-1326
Practice Address - Country:US
Practice Address - Phone:504-286-3880
Practice Address - Fax:504-286-3882
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice